AB1063 PREDICTORS OF ACTIVITY OF ANKYLOSING SPONDYLITIS DURING PREGNANCY
Authors: M. Ajdynan, N. Melkonyan, E. Guryanova, N. Zhuravleva, V. Diomidova
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The ratio of men and women suffering from ankylosing spondylitis (AS) approaches 1:1. Many women aged 30-40 think about motherhood, which makes it important to study the problem of pregnancy in AS. <h3>Objectives</h3> Assess predictors of AS activity during pregnancy. <h3>Methods</h3> The study included 38 pregnant women who met the New York criteria for ankylosing spondylitis, 1984. The average age of patients was 32.6±6.8 years, age at the onset of the disease was 22.8±12.9 years, disease duration was 132, 9±67.3 months The BASDAI index for 1-3 months before conception, in the I, II and III trimesters averaged 2.2±1.85; 2.7±1.72; 3.3±1.87 and 3.4±2.15, respectively. 11 (28.9%) patients received genetically engineered biological preparations (GEBP) 1–3 months before pregnancy, 8 (21.05%) patients in the month of conception, 4 (10, 5%), 4 (10.5%) and 1 (2.6%) women, respectively. Non-steroidal anti-inflammatory drugs in I, II and III (up to 32 weeks) trimesters were taken by 11 (28.9%), 23 (60.5%) and 16 (42.1%) women, respectively. 25 (65.7%) women planned an observed pregnancy. Most of the patients (n = 28) were included in the study in the first trimester of gestation, 7 - in the II, 1 - in the III trimester. The visits were carried out at 10-11, 20-21 and 31-32 weeks of pregnancy. <h3>Results</h3> In the first trimester of pregnancy with the level of activity according to BASDAI, there were the following significant correlation coefficients: the level of BASDAI (rs=0.71) and back pain (rs=0.71) 1-3 months before conception, smoking experience (rs=0, 39), pregnancy planning with a rheumatologist (rs=-0.35), p&lt;0.05 in all cases. In the second trimester, we can talk about the effect on the activity of the level of BASDAI in the first trimester (rs=0.33) and the fact of pregnancy planning (rs=-0.79). In the third trimester, BASDAI activity was influenced by early follow-up with a rheumatologist (rs=-0.37), pregnancy planning (rs=-0.52), exercise therapy in the third trimester (rs=-0.37). Risk factors for high AS activity (BASDAI&gt;4) were high AS activity 1-3 months before conception (odds ratio (OR) in the I and II trimesters - 23 and 7, respectively; 95% CI; p&lt;0.01), lack of pregnancy planning (OR for trimesters 9.2; 32.5 and 15.9, respectively; 95% CI, p&lt;0.01), the abolition of biologics on the eve of pregnancy and in the first trimester (OR in the II and III trimesters - 23.9 and 22.4, respectively; 95% CI, p&lt;0.01). In addition, risk factors for high AS activity in the third trimester were BASDAI&gt;4 in the first (OR - 7.1; CI 95%, p&lt;0.05) and second trimesters of pregnancy (OR - 9.55; CI 95%, p &lt;0.05). <h3>Conclusion</h3> Lack of pregnancy planning, the value of the BASDAI index at the time of conception and in the first trimester of pregnancy, the abolition of biologics 1-3 months before conception and in the first trimester are predictors of AS activity throughout the gestation period. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.